Focal epithelial hyperplasia arising after delivery of metal-ceramic fixed dental prosthesis

Focal epithelial hyperplasia (FEH) is a human papillomavirus (HPV)-induced alteration of the oral mucosa that presents with a clinically distinct appearance. While other HPV-infected lesions such as squamous papilloma, verruca vulgaris, and condyloma acuminatum involve the skin, oral mucosa, and genital mucosa, FEH occurs only in the oral mucosa. The affected oral mucosa exhibits multiple papules and nodules with each papule/nodule being flat-topped or sessile. The affected region resembles the normal color of oral mucosa rather than appearing as a white color since the epithelial surface is not hyperkeratinized. Almost all cases present with multiple sites of occurrence. This rare, benign epithelial proliferation is related to low-risk HPV, especially HPV-13 and -32, and is not transformed into carcinoma. We report a case of FEH that arose on the attached gingiva of an East Asian male adult related to prosthesis without detection of any HPV subtype in HPV DNA chip and sequencing.

Comparative Evaluation of the HPV28 Detection and HPV DNA Chip Test for Detecting and Genotyping Human Papillomaviruses

BACKGROUND: The HPV28 Detection test (Seegene) is a real-time polymerase chain reaction assay that is designed for testing a total of 28 human papillomavirus (HPV) genotypes and estimating the approximate HPV viral load. The aim of this study was to evaluate the clinical applicability of the HPV28 Detection test with regard to the prevalence of HPV infection and distribution of HPV genotypes by using the HPV28 Detection and HPV DNA Chip tests (Biomedlab). METHODS: HPV DNA Chip and HPV28 Detection tests were performed for 500 cervical swab specimens. HPV genotype results were confirmed by sequencing analysis of the specimens that showed discordant results in the 2 test methods. RESULTS: The positive rate of HPV detection determined by using HPV28 Detection and HPV DNA Chip tests were 43.8% and 40.6%, respectively. The sequencing results in 64 discordant specimens that showed single HPV infection in the 2 test methods were in complete agreement with the test results obtained with the HPV28 Detection test. The genotyping results of the HPV28 Detection test were 100% concordant in repeated experiments with HPV-infected specimens that have 12 different HPV genotypes, i.e., types 16, 31, 33, 39, 42, 51, 52, 53, 58, 66, 68, and 70. The HPV28 Detection test was 100-fold more sensitive than the HPV DNA Chip test with serially diluted HPV DNAs. CONCLUSIONS: The HPV28 Detection test can be applied in the clinical field as an HPV genotyping test can accurately identify various HPV genotypes with high specificity and low detection limit.

Detection of HPV Genotypes in Non-genital SeborrheicKeratosis by HPV DNA Chip Analysis / 대한피부과학회지

BACKGROUND: The precise etiology of seborrheic keratosis (SK) is unknown. Genetics, sun exposure and infection have all been implicated as possible factors. Because of its clinical and histopathological similarities to verrucae vulgaris and condyloma acuminatum, human papillomavirus (HPV) has been suggested as a possible causative agent. In the previous studies, HPV were frequently detected in the genital lesions or hair follicles of immunocompromised hosts. OBJECTIVE: A newly introduced HPV detection technique, the HPV DNA Chip analysis, contains 24 HPV probes and it has the advantage of being able to detect 24 types of HPV at once. The purpose of this study was to evaluate the presence of HPV DNA in the nongenital SK of immunocompetant individuals. METHODS: We analyzed 31 biopsy specimens that were taken from patients with nongenital SK, and these specimens were compared with genital warts (the positive control) and distilled water in place of DNA (the negative control) with using HPV DNA Chip analysis and a polymerase chain reaction-based DNA microarray system as the HPV genotyping method. RESULTS: By polymerase chain reaction (PCR), HPV DNA was detected in 2 of the 31 nongenital SK biopsies (6.5%). HPV DNA Chip analysis revealed that 3 of 31 nongenital SKs (9.7%) contained HPV DNA. Two distinct HPV genotypes were detected: HPV type 16 (n=2) and HPV type 42 (n=1). The duration of SK in the HPV positive group was longer than that of the SK in the negative group. The mean age of the patients in the HPV positive group was also older than the mean age of the negative group. There were no different histopathologic findings between the HPV positive and negative SK. CONCLUSION: This study did not provide any concrete evidence that HPV infection might directly play a part in the pathogenesis of nongenital SK. However, two distinct HPV DNA types were identified as types that have never been reported before. Further studies with a larger number of cases of SK are needed to confirm the presence of HPV DNA in nongenital SK and also to determine the role of HPV in the origin of nongenital SK.

Detection of HPV Genotypes in Non-genital SeborrheicKeratosis by HPV DNA Chip Analysis / 대한피부과학회지

BACKGROUND: The precise etiology of seborrheic keratosis (SK) is unknown. Genetics, sun exposure and infection have all been implicated as possible factors. Because of its clinical and histopathological similarities to verrucae vulgaris and condyloma acuminatum, human papillomavirus (HPV) has been suggested as a possible causative agent. In the previous studies, HPV were frequently detected in the genital lesions or hair follicles of immunocompromised hosts. OBJECTIVE: A newly introduced HPV detection technique, the HPV DNA Chip analysis, contains 24 HPV probes and it has the advantage of being able to detect 24 types of HPV at once. The purpose of this study was to evaluate the presence of HPV DNA in the nongenital SK of immunocompetant individuals. METHODS: We analyzed 31 biopsy specimens that were taken from patients with nongenital SK, and these specimens were compared with genital warts (the positive control) and distilled water in place of DNA (the negative control) with using HPV DNA Chip analysis and a polymerase chain reaction-based DNA microarray system as the HPV genotyping method. RESULTS: By polymerase chain reaction (PCR), HPV DNA was detected in 2 of the 31 nongenital SK biopsies (6.5%). HPV DNA Chip analysis revealed that 3 of 31 nongenital SKs (9.7%) contained HPV DNA. Two distinct HPV genotypes were detected: HPV type 16 (n=2) and HPV type 42 (n=1). The duration of SK in the HPV positive group was longer than that of the SK in the negative group. The mean age of the patients in the HPV positive group was also older than the mean age of the negative group. There were no different histopathologic findings between the HPV positive and negative SK. CONCLUSION: This study did not provide any concrete evidence that HPV infection might directly play a part in the pathogenesis of nongenital SK. However, two distinct HPV DNA types were identified as types that have never been reported before. Further studies with a larger number of cases of SK are needed to confirm the presence of HPV DNA in nongenital SK and also to determine the role of HPV in the origin of nongenital SK.

Comparison of Clinical Efficacy between an HPV DNA Chip and a Hybrid-Capture II Assay in a Patient with Abnormal Colposcopic Findings / 대한세포병리학회지

This study was performed to compare the efficacy between a DNA chip method and a Hybrid-Capture II assay (HC-II) for detecting human papillomavirus in patients with intraepithelial lesions of the uterine cervix. From May, 2005, to June, 2006, 192 patients with abnormal colposcopic findings received cervical cytology, HC-II and HPV DNA chip tests, and colposcopic biopsy or conization. We compared the results of HC-II and HPV DNA chip in conjunction with liquid based cervical cytology (LBCC) and confirmed the results of biopsy or conization. The sensitivity of the HPV DNA chip test was higher than HC-II or LBCC. The HPV DNA chip in conjunction with LBCC showed higher sensitivity than any single method and higher sensitivity than HC-II with LBCC. We confirmed that the HPV DNA chip test was more sensitive for detecting HPV in cervical lesions than HC-II, and that it would provide more useful clinical information about HPV type and its multiple infections.

An analysis of HPV subtype in the uterine cervix and clinical usefulness of HPV DNA chip test / 대한산부인과학회지

OBJECTIVE: Human papillomavirus (HPV) has been identified more than 100 HPV subtypes. The distributions of subtypes are different according to nations and regions. We analysed subtype of infection with HPV among women who live in Pusan and surburbs of Pusan. We accessed the clinical usefulness of HPV DNA chip test as a supplementary method of Pap smear in the evaluation of cervical lesion. METHOD: This study was undertaken from January 2002 to January 2005 and the samples were collected from the patients who had abnormal Pap smear. We analysed subtypes of 143 positive cases with HPV DNA chip (Biomedlab) test and estimated pathologic reports of 115 patients except 28 patients who had not biopsy. We investigated pathologic results of 54 of 115 patients who had atypical squamous cells / low grade squamous intraepithelial lesion (ASC/LSIL) in Pap smear and examined high risk HPV in 54 pathologic results. RESULTS: The prevalence of HPV subtypes was 42 cases of HPV-16, 20 cases of HPV- 58, 16 cases of HPV-52, 10 cases of HPV-35, 9 cases of HPV-56, 7 cases of HPV-51, 6 cases of HPV-18 in descending order of incidence in high risk HPV group and 3 cases of HPV-6, 3 cases of HPV-42, 2 cases of HPV-34, 2 cases of HPV-43 in descending order of incidence in low risk HPV group. The results of HPV DNA chip test and 115 pathologic reports were estimated by comparative study. A pure infection with low risk HPV group was detected in low grade lesion. Infection with high risk HPV group was also detected in low grade lesion but was mainly detected in high grade lesion. The pathologic results of 54 patients who had ASC / LSIL in Pap smear were 13 patients had above high grade lesion include 2 cases of invasive carcinoma so false negative rate of Pap smear in the detection of high grade lesion was 24%. CONCLUSION: HPV subtypes were detected HPV 16, 58, 52, 35, 56, 51, 18 types in descending order of incidence and prevalence. Mass study and integrated data from larger population and various regions in many hospitals will be needed. And the supplementary use of HPV DNA chip test may provide clinical usefulness because it can reduce the false negative rate of Pap smear and improve the positive predictive value in the detection of high grade cervical lesion and it enables to decrease the incidence of cervical cancer.

Operational Experience of a Quality Assurance System for HPV DNA Chip Tests / 임상검사와정도관리

BACKGROUND: A new HPV DNA chip test for the infection of 22 HPV genotypes was recently developed in Korea. This test using PCR and hybridization is inherently vulnerable to contamination, and to subjective qualitative test judgment. Hence, it warrants rigorous quality assurance measures. The authors would like to share operational experiences of the guidelines developed at Catholic University Holy Family Hospital. METHODS: Our quality assurance system of HPV DNA chip test comprised external quality controls, inter-laboratory proficiency tests, and internal quality controls. For the external quality controls, we analyzed the results of four years of participation in the quality assurance program by the Korean Laboratory Medicine Quality Assurance Association. The inter-laboratory proficiency tests with BioMedLab were done by single blind tests using patients' samples showing negative, single and multiple infections. The internal quality control dealt with methods to prevent contamination, and with reproduction tests. RESULTS: The results from the external quality control revealed consistency with HPV-16 in 7 trials during 4 years. The inter-laboratory proficiency tests showed a 82% consistency rate, 10 cases of inconsistency showing positive or negative mismatches, and 8 cases of genotypic mismatches. The 10 mismatches were due to the weak laser power of the scanner used in BioMedLab. The genotypic contamination rate found in the internal quality control was 3.3%, and the contamination by HPV-35 with low incidence rate was often observed. The contamination was not easily eliminated by re-tests from hybridization, but 80% of it was removed when re-tested with the remaining samples. The fluorescence intensity was not reproducible nor provide quantitative or semi-quantitative information. CONCLUSIONS: For quality assurance regarding HPV DNA chip tests, we suggest the following be implemented: technical quality control to rule out the false-negative and false-positive during PCR and hybridization; scanner quality control to prevent reading errors; and inter-laboratory proficiency tests.

Clinical Efficacy of HPV DNA Chip test in Human papillomavirus detection of Uterine Cervix / 대한산부인과학회지

OBJECTIVE: This study was performed to investigate the efficacy of HPV DNA chip method for detection and genotyping of various human papillomavirus in the patients with intraepithelial lesions of uterine cervix. METHODS: The study subjects included two hundred patients with abnormal Pap smear from July 2004 to October 2004. After confirmed the pathological status of the cervix with colposcopic biopsy or conization, we evaluated for HPV infection and genotyping with the commercially available Hybrid-Capture II assay (HC-II) and HPV DNA chip. Then we compared the concordance rate between the two methods for the detection of HPV and analysed the HPV genotypes. RESULTS: We compared the results in HPV DNA chip with those in HC-II. In result, the concordance rate between the two methods for the detection of HPV was 85.5% (171 of 200 cases). In 111 patients confirmed the presence of lesions higher than flat condyloma in cervix by pathologc examination, sensitivities of HC-II and HPV DNA chip in detecting HPV were 91.0% and 88.3%, respectively. In HPV DNA chip, HPV-16 was the most frequent type (14.7%) in all patients, the next frequent types were HPV-58 (14.1%) and HPV-18 (9.2%). CONCLUSION: We confirmed that HPV DNA chip method was as sensitive and effective method for detecting HPV in cervical lesions as HC-II. And that it would provide useful clinical information on genotyping and multiple infections of HPV.

Genotyping of Human Papillomavirus Detected with the HPV DNA Chip in Cervical Cancer / 대한산부인과학회지

OBJECTIVE: This study was performed to investigate the efficacy of DNA chip method for detection and genotyping of various human papillomavirus in the patients with invasive cervical cancer in Korea. METHODS: The study subjects included 38 cases of cervical cancer for HPV detection and genotyping, and the commercially available DNA chip was used. Retrospectively cervical specimens of thirty eight patients with pathologically confirmed invasive cancer of the uterine cervix were tested for HPV typing performed by DNA chip method in Samsung Cheil Hospital from September 1999 to October 2000. RESULTS: Among 38 cervical carcinomas, histological examination revealed that 34 (89.5%) cases were squamous cell carcinoma, three (7.9%) were adenocarcinoma and one (2.6%) was small cell carcinoma. In carcinoma patients thirty two cases (84.2%) of invasive carcinoma were positive for at least one type of high risk HPV. Only two woman (5.3%) among the healthy group had HPV positive. We compared the results in HPV DNA chip with those in sequencing. The concordance rate between the two methods for the detection of HPV was 95.7% (67 of 70 cases). CONCLUSION: We confirmed that DNA chip method was a simple, convenient, and effective method for detecting HPV in cervical carcinoma and health women.

The efficacy of HPV DNA chip test in the atypical squamous cell of undetermined significance / 부인종양

OBJECTIVE: This study was performed to investigate the efficacy of DNA chip method for detecting and genotyping of human papillomavirus (HPV) and screening of high-grade CIN (cervical intraepithelial neoplasia) or invasive cancer in the patients with atypical squamous cells of undetermined significance (ASC-US). METHODS: This study was based on 131 cases to be revealed ASC-US by Pap smear for the cervical cancer screening from July 2004 to Octorber 2004. They were evaluated by HPV DNA chip test, Cervical colposcopy and directed biopsy, and cone biopsy. The results of type 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 54, 56, 58, 59, 66 and 68 in HPV DNA chip test were categorized as high risk HPV. We evaluate the detection rate of the high-grade CIN and invasive cancer by HPV DNA chip test. RESULTS: The incidence of high risk HPV DNA was 51.1% (67/131). Twelve of 131 (9.2%) were diagnosed as high-grade CIN or CIS on histology. The detection rate of high risk HPV DNA in high-grade CIN and invasive cancer was 83.3% (10/12). The detection rate of high risk HPV DNA was 36.0% (31/86) in normal or reactive, and 83.3% (10/12) in CIN II or above on histology. Higher the grade of biopsy, more the detection rate of high risk HPV DNA by HPV DNA chip test. CONCLUSION: The use of HPV DNA chip test in patients with ASC-US may be useful in detection of high-grade CIN or invasive cancer.

A Study for the Prevalence of High-risk HPV Subtype in Uterine Cervical Neoplasia of Korean Women / 대한산부인과학회잡지

OBJECTIVE: Many studies about Human Papilloma virus (HPV) that is a causative factor uterine cervical cancer have been established and more than 85 HPV types have been identified. The distributions of cancer-associated HPV types are different according to nations and region. To estimate the extent of infection with common HPVs among Korean women, we have examined specimens of various cervical lesion. METHODS: The samples were collected from 135 Korean women visiting the Department of Obstetrics and Gynecology, Chunan Hospital Soonchunhyang University, Chunan, Korea. DNA was extracted from the specimen and 112 samples were available. HPV subtype were identified using HPV DNA Chip and P-E ABI prism 310 DNA Autosequencer. RESULTS: HPV DNA was detected in 98 cervical sample (80.3%) out of 122 cases. HPV typing in the samples revealed the prevalence of HPV 16 in 56 cases (57.1%), followed by HPV 58 in 14 cases (14.3%) and HPV 18 were only 2 cases (2.0%) among 98 HPV (+) cases. HPV-negative case was 34.8% and HPV-positive case was 65.2% in CIN I group. HPV-negative case was significantly high in CIN I group. HPV-positive cases were 83 cases (83.8%) in the cases advanced more than CIN I. There were significant difference comparing CIN I group. The order of cervical neoplasia-associated type were HPV-16, -58, -52 and ect. The pattern is similar to the results reported in China and Japanese. CONCLUSION: The finding indicated that the overall prevalence of HPV among Korean women is similar to that in China and Japanese, the distinct high proportion of HPV 58 infection deserves attention. The prevalence of high-risk HPV in Korean women is different from the one in western women but accumulated data from larger population and different regions in Korea is needed.

Clinical Significance of HPV DNA Chip Test in the Management of Atypical Squamous Cells of Undetermined Significance / 대한산부인과학회잡지

OBJECTIVE: Cervical intraepithelial neoplasia (CIN) and invasive cervix cancer were detected in some cases of atypical squamous cells of undetermined significance (ASCUS) PAP smear. So it is reasonable to evaluate and manage ASCUS PAP smear. In this study, we attempted to assess the clinical significance of a cytologic diagnosis of ASCUS and determine the usefulness of HPV DNA chip test (which is a new diagnostic method for HPV) in management and evaluation of ASCUS patients. METHODS: This study was performed from November 2001 to June 2002 and included 48 cases of ASCUS. They were evaluated by HPV DNA chip test and the pathology was evaluated by punch biopsy, cone biopsy or hysterectomy. The result of type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 and 69 in HPV DNA chip test were categorized as high risk. RESULTS: The rate of CIN II or above in ASCUS was 18.8% (9/48). The detection rate of high risk HPV DNA in ASCUS was 41.7% (20/48). The detection rate of high risk HPV DNA was 30.6% (11/36) in normal or reactive, 33.3% (1/3) in CIN I, 80% (4/5) in CIN II, 100% (2/2) in CIN III, 100% (2/2) in invasive cervix cancer. Higher the grade of pathology, more the detection rate of high risk HPV DNA chip test. The sensitivity for the prediction of CIN II or above by HPV DNA chip test was 88.9% and specificity was 69.2%, respectively. CONCLUSION: The use of HPV DNA chip test in patients with ASCUS may provide usefulness in detection of CIN II, CIN III and invasive cervix cancer.